0001437749-22-015938.txt : 20220627 0001437749-22-015938.hdr.sgml : 20220627 20220627084404 ACCESSION NUMBER: 0001437749-22-015938 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20220615 FILED AS OF DATE: 20220627 DATE AS OF CHANGE: 20220627 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jacob Jeffrey E. CENTRAL INDEX KEY: 0001934189 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39468 FILM NUMBER: 221041659 MAIL ADDRESS: STREET 1: 712 VISTA BLVD #305 CITY: WACONIA STATE: MN ZIP: 55387 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Panbela Therapeutics, Inc. CENTRAL INDEX KEY: 0001029125 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 870543922 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 712 VISTA BLVD #305 CITY: WACONIA STATE: MN ZIP: 55387 BUSINESS PHONE: 9524791196 MAIL ADDRESS: STREET 1: 712 VISTA BLVD #305 CITY: WACONIA STATE: MN ZIP: 55387 FORMER COMPANY: FORMER CONFORMED NAME: Sun BioPharma, Inc. DATE OF NAME CHANGE: 20150911 FORMER COMPANY: FORMER CONFORMED NAME: Cimarron Medical, Inc. DATE OF NAME CHANGE: 20150602 FORMER COMPANY: FORMER CONFORMED NAME: CIMARRON SOFTWARE INC DATE OF NAME CHANGE: 19961217 3 1 rdgdoc.xml FORM 3 X0206 3 2022-06-15 0 0001029125 Panbela Therapeutics, Inc. PBLA 0001934189 Jacob Jeffrey E. 712 VISTA BLVD #305 WACONIA MN 55387 1 Common Stock 261931 D Common Stock 17771 I Jointly with spouse Common Stock 54374 I By trust Stock Option (right to buy) 1.2400 2022-09-26 Common Stock 41766 D Stock Option (right to buy) 1.4700 2022-09-26 Common Stock 35543 D Stock Option (right to buy) 0.2200 2030-12-28 Common Stock 91523 D Stock Option (right to buy) 0.2200 2030-12-28 Common Stock 177715 D Warrants (right to buy) 5.6300 2023-02-01 Common Stock 5174 I By trust Fully vested. Exhibit List: Power for Attorney EX-24 /s/ Joshua L. Colburn, Attorney-in-Fact 2022-06-25 EX-24 2 jacobpoa.txt POWER OF ATTORNEY EX-24 I, Jeffrey E. Jacob hereby authorize and designate each of Jennifer K. Simpson, Susan Horvath, W. Morgan Burns, Joshua L. Colburn, Vilena Nicolet, and Amra Hoso signing singly, as my true and lawful attorney-in-fact to: (1) execute for and on my behalf, in my capacity as an officer and/or director of Panbela Therapeutics, Inc. (the "Company"), Form ID or Forms 3, 4 and 5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 (the "Exchange Act") and the rules and regulations promulgated thereunder and other forms or reports on my behalf as may be required to be filed in connection with my ownership, acquisition, or disposition of securities of the Company, including Form 144 and Schedule 13D or Schedule 13G; (2) do and perform any and all acts for and on my behalf, which may be necessary or desirable to complete and execute any such Form ID, Forms 3, 4 or 5, Form 144, Schedule 13D or Schedule 13G and timely file such form with the Securities and Exchange Commission and any stock exchange or similar authority; and (3) take any other action of any type whatsoever in connection with the foregoing which, in the opinion of such attorney-in-fact, may be to my benefit, in my best interest, or legally required of me, it being understood that the statements executed by such attorney-in-fact on my behalf pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion. I hereby further grant to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as I might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. I herebyz acknowledge that the foregoing attorneys-in-fact, in serving in such capacity at my request, are not assuming, nor is the Company assuming, any of my responsibilities to comply with Section 16 of the Exchange Act. This Power of Attorney shall remain in full force and effect until I am no longer required to file Form ID or Forms 3, 4 and 5 with respect to my holdings of and transactions in securities issued by the Company, unless earlier revoked by me in a signed writing delivered to the foregoing attorneys-in-fact. Notwithstanding the foregoing, if any such attorney-in-fact hereafter ceases to be at least one of the following: (i) a partner of Faegre Drinker Biddle & Reath LLP or (ii) an employee of Faegre Drinker Biddle & Reath LLP, then this Power of Attorney shall be automatically revoked solely as to such individual, immediately upon such cessation, without any further action on my part. I hereby revoke all previous Powers of Attorney that have been granted by me in connection with my reporting obligations under Section 16 of the Exchange Act with respect to my holdings of and transactions in securities issued by the Company. IN WITNESS WHEREOF, I have caused this Power of Attorney to be duly executed as of this 15th day of June 2022. /s/ Jeffrey E. Jacob